As a physician, Dr. Kenneth Hoffer is a bit of an oddity. He has never had to wrangle with health maintenance organizations or managed care contracts. He hasn’t had to deal with the AIDS epidemic or the uninsured, and he hasn’t been affected by the county health care crisis.

Although he doesn’t work on the front lines of medical care, Hoffer, a Santa Monica ophthalmologist, was recently elected president of the Los Angeles County Medical Association. His election comes at a critical time for the organization, which has steadily been losing members over the last decade, from a high of 10,360 in 1988 to 7,425 last year.

By his own account, Hoffer is a bit of an aberration for the job. The 56-year-old physician prefers to travel by train rather than by plane. He is a solo-practitioner who has worked since 1974 as a specialist in cataract and lens-implant surgery. Many of his clients are either from well-to-do households or covered by private insurance. He is also the first ophthalmologist to be elected president of LACMA.

He admits he doesn’t know much about the AIDS epidemic, public health or HMO contracts. But those issues have little to do with his main goal: to streamline the county medical association’s structure.

He hopes to combine the organization’s two governing bodies into one. LACMA is overseen by a board of trustees that handles financial matters, and a council that handles policy. They meet on separate days, have different members and don’t coordinate their activities well, Hoffer said. Having one group that handles both finance and policy would be better for responding to the concerns of local doctors disheartened by the HMO system and their low reimbursement rates, he said.

Many physicians felt LACMA should have saved them from being trapped in low-paying HMO contracts, Hoffer said, but that was impossible.

“If they thought about it, there was nothing LACMA or the California Medical Association could have done to prevent it,” Hoffer said. “So LACMA gets a bad rap. To offset that, you really have to educate physicians and prospective physicians that we are there to defend them and prevent many onerous things from happening, such as when Gov. Jerry Brown wanted to eliminate the need for medical licensure and allow anybody to practice medicine.”

One of Hoffer’s areas of expertise is running organizations. He founded the American Society of Cataract & Refractive Surgery in 1974 and ran it for six years. In the mid-1980s, he reorganized the California Academy of Ophthalmology.

“He’s a pretty clear thinker,” said Dr. Brian Johnston, an emergency room doctor who is a past LACMA president. “I don’t agree with everything he says and he doesn’t agree with everything I say. But we agree we have to bring in new members.”